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Biomedical subjects

D Maguire

Publications and source records attributed to D Maguire.

At least 55 records · Page 3Linked to original sources
PubMed1996

Neonatal nurse practitioners: identity as advanced practice nurses.

OBJECTIVE: To define how neonatal nurse practitioners (NNPs) perceive their identity as advanced practice nurses. DESIGN: Non-experimental descriptive and correlational survey. SETTING: Nationwide random sample drawn from NNPs certified by the National Certification Corporation. PARTICIPANTS: Two hundred fifty-eight neonatal nurse practitioners practicing in neonatal intensive-care units across the United States. MAIN OUTCOME MEASURES: Neonatal Nurse Practitioners indicated on a visual analogue scale at which point their philosophy of practice fell on a continuum from nursing to medicine and specified on a 5-point bipolar Likert scale how various role socialization factors influenced their identity. RESULTS: The NNPs predominantly were certificate-prepared and aligned themselves with a medical philosophy. Those NNPs who were master's-prepared (p < .01), precepted by another NNP (p < .05), espoused a philosophy of nursing (p < .001), belonged to a professional nursing organization (p < .05), and had an NNP role model (p < .001) were more likely to have a strong nursing identity (95% confidence interval). CONCLUSIONS: The issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care need further exploration. These data support the American Nurses' Association mandate of graduate nursing education for advanced nurse practitioners.

Adult↗
PubMed1995

Creating a successful environment for neonatal nurse practitioners.

Factors that contribute to the neonatal nurse practitioner (NNP) practice environment have emerged from research grounded in the results of a nonexperimental, descriptive, and correlational study that described the role and nursing identity of 258 NNPs. These factors may be used as prescriptions for developing successful NNP environments or to strengthen a current practice. Nursing management has a responsibility to identify factors that enhance nursing identity of NNPs and to plan strategies to operationalize those factors to provide an optimal environment in which NNPs can practice to their fullest potential. Implications are raised for nursing administration and education to address the issues of role differentiation, socialization, and identity of advanced practice nurses in tertiary care.

Humans↗
PubMed1995

Advanced practice nursing in the neonatal intensive care unit.

The advanced practice roles of clinical nurse specialist and neonatal nurse practitioner have enjoyed challenge and success in the neonatal intensive care unit (NICU). This article provides a historic perspective and role descriptions of advanced practice roles in the NICU, describes a theoretical framework for development of the graduate neonatal nurse practitioner, and uses this framework to describe the neonatal advanced practice nurse of the future.

Humans↗
PubMed1994

Sodium balance in very-low-birth-weight infants.

Maintaining sodium balance in the VLBW infant is not straightforward. Several predisposing factors appear in more than one imbalance constellation. In addition, the same patient circumstance can produce two types of imbalance. Understanding the physical properties of electrolytes and water enables critical care nurses to anticipate outcomes of specific situations in the neonatal ICU. Careful assessment of renal function, urine output, and water balance are crucial in determining proper treatment of sodium balance disorders. The high potential risk of errors in the neonatal ICU requires verification of all fluid and electrolyte orders, as well as serial safety checks of IV fluids and additives to avoid complications. An expert nurse's ability to predict the needs of VLBW infants places the nurse in a pivotal position to recognize subtle changes before actual physiologic change occurs. Although the multiple variations can be confusing to the bedside clinician, sorting through them helps in selecting interventions that are timely and improve the outcomes and morbidity of our smallest patients at risk.

Humans↗
PubMed1994

Drug compatibilities and infusion sites.

Many medications commonly used in the NICU are compatible, but are not routinely coinfused. By minimizing infusion sites, nurses contribute to protecting our smallest patients against infection and stress. No single handbook or resource provides comprehensive information about drug compatibilities. Clinicians must cross-reference several sources to guide their practice.

Catheters, Indwelling↗
PubMed1993

A monoclonal antibody to recombinant human IFN-alpha receptor inhibits biologic activity of several species of human IFN-alpha, IFN-beta, and IFN-omega. Detection of heterogeneity of the cellular type I IFN receptor.

A cDNA encoding a 63-kDa human IFN-alpha R (hIFN-alpha R) has recently been cloned. Mouse cells transfected with this cDNA failed to show any signal transmission for IFN-beta, suggesting the involvement of additional chains in the receptor complex. We have expressed in Escherichia coli and COS 7 cells a soluble recombinant protein (sIFN-alpha R) comprising the extracellular domain of the hIFN-alpha R fused at the carboxyl terminus to a sequence of five histidine residues. The sIFN-alpha R was affinity purified and used to generate mAb. One mAb, 64G12, which recognized the cellular receptor as well as the recombinant proteins was found to neutralize the biologic activity of IFN-alpha, -beta, and -omega and natural type I IFN, but not IFN-gamma. To our knowledge, this is the first report of a neutralizing mAb against the human IFN-alpha R. Interestingly, we found that the affinity of this antibody for the cellular receptor depended on the cell line used. These results provide strong evidence that the cloned hIFN-alpha R chain is required for binding and signal transmission of all subspecies of type I IFN and suggest a structural heterogeneity of the receptor at the cell surface.

Animals↗
PubMed1992

Integration of a barcode reader with a commercial flow cytometer.

This report describes the application and installation of a barcode reader on a standard EPICS Elite flow cytometer. The barcode reader system eliminates keyboard entry of sample information on the cytometer. The system automates the transfer of sample information already present in our laboratory database to the cytometer at run time. The system uses a standard "off-the-shelf" bar code wand with a personal computer keyboard interface and requires no additional software at run time. No typing of sample information is required by the operator at any stage of normal sample operation at the cytometer. All operations are automatically coded into the cytometry software using the macro functions of the software. Tubes are inserted into the tube reader and sample information is transferred automatically into the cytometer. We have found that the system allows rapid and continuous operation of routine clinical and research samples. This automated data entry also reduces the possibility of data input errors.

Electronic Data Processing↗
PubMed1990

Different pathways mediate virus inducibility of the human IFN-alpha 1 and IFN-beta genes.

Multimerization of GAAANN generates sequences frequent in virus-inducible promoters. We distinguished different types of (GAAANN)4 sequences mediating virus inducibility. Type I (NN = GT, GC, CT, or CC) responds to IFNs and to IRF-1 and causes silencing. Type II (NN = TG) and type III (NN = CG) neither silence nor respond to IRF-1 or IFN. Type III mediates constitutive transcription and binds the constitutive IEFga factor, whereas type II binds the novel "TG protein". IFN-beta and IFN-alpha 1 promoters contain different response elements: The former has a type I-like sequence (PRDI) and an NF-kappa B-binding sequence (PRDII); the latter has a type II-like "TG sequence" and possibly additional elements but does not bind NF-kappa B. Type I, type II, and NF-kappa B elements represent three distinct terminal pathways mediating virus induction.

Animals↗
PubMed1990

Nicardipine versus placebo for the treatment of postoperative hypertension.

Postoperative hypertension can cause serious complications, including bleeding from fresh anastomoses, cardiovascular accident, and myocardial ischemia. Therefore rapid control of blood pressure is essential to prevent poor outcome. In this study, 30 American Society of Anesthesiologists class I and II patients who did not have cardiac surgery and subsequently developed postoperative hypertension were randomly assigned to receive either nicardipine, a new dihydropyridine calcium channel blocker, or placebo. Intravenous nicardipine was given as a loading bolus of 10 mg/hr for 5 minutes and was titrated to 15 mg/hr if needed to achieve a therapeutic response. After therapeutic response, intravenous nicardipine was decreased to 3 mg/hr and subsequently titrated in increments of 1.0 to 2.5 mg/hr to maintain blood pressure control. Systolic and diastolic blood pressures during titration and maintenance did not differ significantly from preoperative levels in patients treated with nicardipine. The mean time to therapeutic response for the nicardipine-treated group was 8.67 +/- 1.46 minutes, and the median time to offset of action was 15 minutes. Eleven of the 12 patients who received placebo were crossed over to antihypertensive therapy, and of these, 10 received intravenous nicardipine. In this group all achieved therapeutic response in 7.3 +/- 1.18 minutes. The usefulness of intravenous nicardipine for postoperative hypertension was demonstrated in this study by: (1) the rapid control of blood pressure, (2) its continued efficacy during maintenance, and (3) little need to adjust dosage to control blood pressure.

Dose-Response Relationship, Drug↗
PubMed1989

Anaesthesia and Rett syndrome: a case report.

Rett syndrome is a neurological disorder of females characterized by dementia, autism, movement disorders and an abnormality of respiratory control. A 14-year-old girl with Rett Syndrome underwent spinal fusion surgery under general anaesthesia. No exacerbation of the respiratory control defect with surgery and anaesthesia was observed. Hypothermia, ongoing blood loss and a normal anion gap acidosis were encountered, but were not attributable to features of this disorder.

Adolescent↗
PubMed1984

Immunosuppression by human skin cancers.

Biopsy samples from normal skin (12 samples) and skin lesions diagnosed as either basal cell (17 cases) or squamous cell carcinoma (5 cases) were frozen, disrupted and extracted with aqueous buffer. The sterilised extract was added to an in vitro system of cultured bovine lymphocytes. The response of the lymphocytes to PHA was measured by tritiated thymidine uptake. Extracts of both basal cell and squamous cell cancers inhibited normal PHA stimulation of lymphocyte mitogenesis. Blastogenesis was reduced by more than 50% by all of the cancer extracts tested. In contrast, similar extracts from normal skin showed less than 40% inhibition.

Animals↗